Yoğun bakım trakeostomi deneyimlerimiz; 103 olgu

Year 2018, Volume: 8 Issue: 3, 197 - 200, 30.09.2018

Fatma Koçyiğit , Serpil Bayındır

https://doi.org/10.16899/gopctd.403178

Abstract

Amaç: Bu çalışmada, yoğun bakım ünitemizde
Griggs tekniği ile açılan perkütan trakeostomilerin işlemlerinin erken
komplikasyonları sunmayı amaçladık.

Gereç ve Yöntemler: Çalışmamızda, 2010-2016 yılları arasında Griggs tekniği ile perkütan
trakeostomi açılan, 37 erkek 66 kadın olgu incelendi. Boyun yapısı normal olan
ve hemostatik bozukluğu olmayan hastalar çalışmaya dahil edildi.

Bulgular: Hastaların hepsinde perkütan trakeostomi başarılı bir şekilde açıldı.
Komplikasyon olarak 6 hastada minör kanama, 15 hastada hipotansiyon,  1 hastada yara yeri enfeksiyonu görüldü. Hastalarda
pnömotoraks, ciddi hipoksi ve mortalite görülmedi.

Sonuç: Griggs tekniği ile perkütan trakeostomi
açılmasının yatak başında kısa sürede uygulanan, düşük komplikasyon oranına
sahip bir yöntem olduğu kanaatine varıldı.

Keywords

Perkütan trakeostomi, yoğun bakım, komplikasyon

Our tracheostomy experiences in intensive care; 103 cases

Abstract

Objective:
In this study we aimed to present the early complications of the percutaneous tracheotomies
with Griggs technique in our intensive care unit.

Materials and Methods: In this study , we investigated 103 patients. Percutaneous tracheostomy with Griggs method were performed to all patients. This study performed between 2010-2016. 37 male, 66 female patients were investigated. Normal tracheal and neck structurel patients were selected for technique. There were also no hemostatic problem. Peroperative and postoperative complications were recorded.

Results: Percutaneous tracheostomies were performed succesfully in all patients.  Minör bleeding were seen on 6 patients,  hypotension on 15 patients, wound infection on 1 patient. Pneumothorax, serious hypoxia and mortality were not seen during percutaneous tracheostomy.

Conclusion: We conclude that percutaneous tracheostomy
with Griggs technique is performed in a short time at the bedside and has a low
complication ratio.

Keywords

Percutaneous tracheostomy, intensive care unit, complication

References

• 1.Plummer AL, Gracey DR. Consensus conference on artificial airways in patients receiving mechanical ventilation. Chest 1989; 96: 178-180.
• 2. Marsh HM, Gillespie DJ, Baumgartner AE. Timing of tracheostomy in the critically ill patients. Chest 1989; 96: 190193.
• 3.Mallick A, Bodenham AR. Tracheostomy in critically ill patients. Eur J Anaesthesiol 2010; 27: 676-682. 3
• 4. Whited RE. A prospectivestudy of laryngotracheal sequelae in termintubation. Laryngoscope 1984; 94: 367-377.
• 5. Shelden CH, Pudenz RH, Tichy FY. Percutaneous tracheotomy. JAMA 1957; 165: 2068-2070.
• 6.Toy FJ, Weinstein JD. A percutaneous tracheostomy device. Surgery 1969; 65: 384-389.
• 7. Ciaglia P, Firsching R, Syniec C. Electivepercutaneous dilatational tracheostomy: a new simple bedside procedure: preliminaryreport. Chest 1985; 87: 715-719.
• 8. Schachner A, Ovil Y, Sidi J. Percutaneous tracheostomy: A newmethod. Crit Care Med 1989; 17: 1052-1056.
• 9. Griggs WM, Worthley LIG, Gilligan JE, Thomas PD, Myburg JA. A simple percutaneous tracheostomy technique. Surgery 1990; 170: 543-545.
• 10.Anon JM, Gomez V, Escuela P, et al. Percutaneous tracheostomy: comparison of Ciaglia and Griggs techniques. Crit Care 2000; 4: 124-8.
• 11. Rao BK, Pande R, Sharma SC, et al. Percutaneous tracheostomy. Annals of Cardiac Anaesthesia 2003; 6: 19-26.
• 12.Caruso, DM, al-Kasspooles, MF, Matthews, MR, et al Rationalefor “early” percutaneous dilational tracheostomy in patients with burn injuries. J BurnCare Rehabil 1997;18,424-428.
• 13. Diehl, JL, El Atrous, S, Touchard, D, et al Changes in thework of breathing induced by tracheotomy in ventilator-dependent patients.Am J Respir Crit Care Med 1999;159,383-388
• 14. Hazard P, Jones C, Benitone J. Comparative clinical trial of standard operative tracheostomy with percutaneous trache-ostomy. Crit Care Med 1991;19:1018-24.
• 15. Crofts SL, Alzeer A, McGuire GP, et al. A comparison of percutaneous and operative tracheostomies in intensive care patients. Can J Anaesth 1995;42:775-79
• 16. Sağıroğlu EA, Ağkoç E, Doğan Y, ve ark. Yoğun Bakım Ünitesinde Perkütan ve Cerrahi Trakeostomilerin Karşılaştırılmsı.Göztepe Dergisi 2010;25(2): 67-70.
• 17. Çiçek M, Gedik E, Yücel A, Köroğlu A, Ersoy MÖ. Griggs tekniği ile açılan perkütan trakeotomi sonuçlarımız. İnönü Üniversitesi Tıp Fakültesi Dergisi 2007; 14: 17-20.
• 18. Akıncı İÖ, Tuğrul S, Özcan P, ve ark. Perkütan dilatasyonlu ve forsepsli trakeostomi tekniklerinin karşılaştırılması. Türk Anestezi Reanimasyon Cemiyeti Mecmuası 2001; 29: 547-550.
• 19. Friedman Y. Comparison of percutaneous and surgical tracheostomies. Chest 1996;110(2):480-485.
• 20. Kaplan A, Yaşar MA, Özer AB. Griggs, Perkütwist ve Ciaglia Perkütan Trakeostomi Yöntemlerinin Karşılaştırılması. Fırat T ıp Dergisi 2010;15(4):173-177.
• 21. Byhahn C, Wilke HJ, Lischke V, et al. Bedside percutaneous tracheostomy: clinical comparison of Griggs and Fantoni techniques. World J Surg 2001; 25: 296-301.
• Anon JM, Gomez V, Escuela P, et al. Percutaneous tracheostomy: comparison of Ciaglia and Griggs techniques. Crit Care 2000; 4: 124-8.
• 22.Van Heurn LW, Van Geffen GJ, Brink PR. Clinical experience with percutaneous dilatational tracheostomy: report of 150 cases. Eur J Surg 1996; 162: 531-5.
• 23.Friedman Y, Mizock BA. Percutaneous versus surgical tracheostomy: procedure of choice or choice of procedure. Crit Care Med 1999; 27: 1684-5.